Clinical workflow, apparatus, method and system for providing indirect to direct telemedicine eye examinations using portable medical equipments connected via emulation software

ABSTRACT

The present disclosure relates to a clinical workflow, method, system and apparatus for performing an remote ocular health examination of a patient using medical equipment adapted to apparatus and emulating software and remote administration tool technology application. According to various embodiments portable medical equipment kit (OEK) can be assembled anywhere in the world connected to a computer. The MCB will have proprietary software to provide indirect to direct connection via layers. In an example embodiment, a method includes instructing a patient to position their eyes onto a camera where the image of the eyes are viewed on computer software. Where an on demand doctor can control the software that controls the cameras and review real time or near realtime the ocular images or videos via a indirect to direct connection to the main control base via a remote administration tool technology and emulating software using an internet connection.

RELATED APPLICATIONS

This U.S. patent application is a continuation of U.S. patent application Ser. No. 17/180,789 filed Feb. 20, 2021 titled “Worldwide indirect to direct on-demand eye doctor support refraction system via a remote administration tool mobile application on any portable electronic device with broadband wireless cellular network technology 4G, 5G, 6G or Wifi wireless network protocols to interconnect both systems.”. which is a continuation of U.S. provisional patent application No. 62/982,040 filed Feb. 26, 2020 titled “Indirect to direct on demand eye doctor support refraction system via remote administration tool using any portable digital device by 4G, 5G, 6G or Wifi to interconnect both systems.”.

FIELD OF INVENTION

This clinical workflow, apparatus, method and system relates to conducting an (ID) indirect to direct ocular health examinations, prescription extensions or submissions system via remote administration tool technology, an adapter apparatus (AA), proprietary emulating software, control softwares and mobile applications. The system also may or may not have the ability to switch to direct remote capabilities. Specifically, these systems pertains to the use of ocular health medical equipment kits anywhere in the world that can be remotely controlled and viewed by a remote eye doctor for a telemedicine consultation. The ocular health medical equipment kit contains portable digital slit-lamp, two iris copes, a camera headset apparatus, wireless router, smartphone, ocular tonometer and two portable computers.

At least one of the portable computers has ocular health cameras, software, an apparatus with adapter, proprietary emulating software, electronic medical records software, mobile applications and remote administration tool (RAT) and/or (RAS) remote access software applications. The secondary portable computer works as a vision chart, duo chrome and astigmatic dial chart. The use of cellphone wireless networks or wifi wireless networks provide a remote eye doctor to provide indirect to direct real time or near real time telemedicine ocular health screening or examination to a remote patient anywhere in the world with the connection to portable or non portable medical equipment.

BACKGROUND OF INVENTION

There is a disparity of vision care coverage worldwide, not because of a shortage of vision care providers, but due to a shortage of vision care providers that are within close proximity to their patients and due eye doctor office hours. Uneven vision care coverage leads to underserved populations from obtaining much needed emergency ocular health examination, which decreases their overall quality of life and limits their abilities of daily living. Currently, many emergency room, clinics, mobile clinics, hospitals, opticals, optometric practices, and ophthalmology practices struggle to find a cost-effective strategy that can supply these populations with adequate and easily accessible opportunities for precise, 24 hour, tailored emergency ocular health screenings or examination from a professional vision care provider.

The present invention system seeks to provide adequate and easily accessible opportunities for underserved populations worldwide to obtain precise, tailored telemedicine ocular health screenings and examinations services from a remote vision care provider independent of timezone. Consequently, it seeks to improve the underserved population's overall quality of life and increase their abilities of daily living. This system proposes to achieve this through the use of remote administration tool technology, adapters, softwares, telemedicine video audio connection, mobile applications or software, proprietary emulating softwares, remote access or remote control software to interconnect both systems via ethernet, wifi or cellphone wireless networks worldwide.

BRIEF DESCRIPTIONS OF THE DRAWINGS

FIG. 1 —illustrates a workflow diagram of a method for performing ocular medical health check-ups (TPA) Therapeutic pharmaceutical agent check-ups.

FIG. 1A—illustrates a workflow diagram of a method for performing a contact lens prescription extension.

FIG. 2 —illustrates an embodiment of a group of devices that can be used by a controller providing service via a smartphone application, program or website that can be used in a smartphone, virtual reality headsets, augmented reality headsets, smartwatches or laptops, or any computer system, where the application mobile application, program, or website has a graphical user interface with sign-up menu to log in, section to put remote controllers (health care professional, or eye doctors) name, health care providers license numbers from each state or country, nation provider identification number (NPI), type of health care provider, cellphone number, and way to receive payment for service.

FIG. 3 —Illustrates embodiments of one of a plurality of health care providers and/or eye doctors portable electronic devices with its graphical user interface running at least one program, website, or mobile application on the health care provider's smartphone. Where connecting the device and location of the remote facility gives availability for service location and time for needed remote eye doctor booking, where the controller can select the date, time, and location to provide service and receive an electronic message or text message of the user name, password and day and time to provide service, where the eye doctor can connect to the (MCB) to view control at least one of a plurality of medical equipment from at least one computer system and at least one controller's computer system.

FIG. 4 —Illustrates pictorial diagram embodiment of a group of ocular examination equipment kits and secure casing that are portable in nature and can be sent or receive anywhere in the world to establish a remote medical facility setup, where the ocular examination kit have a plurality of wired connection devices, two iris-copes, one (MCB) computer system, fluorescein sodium kit, remote vision chart system, portable slit-lamp with or without robotic adapters and computer system, cellphone wireless router system, (MCB) adapter and a smartphone with an operating system.

FIG. 4A—Illustrate pictorial diagram embodiment of a group of ocular examination equipment kits and secure casing that are portable in nature and can be sent or receive anywhere in the world to establish a remote medical facility setup. Where the ocular examination kit have a plurality of wired cable connection devices, two iris-copes, at least one extra (MCB), an automatic digital lens-meter, at least one cellphone wireless router, smartphone with an operating system and at least one phoropter or refractor. Where the refractor or horopters can be an automatic objective refractor, an automatic or digital phoropter and/or subjective refraction equipment, variable focus liquid lens refractor, and/or liquid lens subjective refractor or phoropter,

FIG. 5 —Illustrate pictorial diagram embodiment of the connection of the ocular examination kits with at least one or more equipment can be connected to a secondary computer called the (MCB) in a remote medical facility anywhere in the world. Where a remote administration tool, screen share, screen control and screen mirror connection is established between the remote distance eye doctor or health care professional and the remote medical facility via the (MCB) and a smartphone connection via a HIPPA compliant audio video call where audio video call is mirrored to a television screen in the remote medical facility.

FIG. 6 —Illustrate pictorial diagram embodiment assistant or (Assistant or technician) connecting with live remote eye doctor where the (Assistant or technician) or eye doctor can collecting retinal images via “store and forward” technique with the option of having remote control eye doctor control the softwares the controls the retinal camera and also take and review the images via real-time Tele-imaging via remote administration tool, emulating softwares, screen share, screen control, and screen mirror softwares via a the any type of internet network or network. Where the remote vision chart is set to on the wall to remotely review patient visual acuities before or after.

FIG. 7 —Illustrate pictorial diagram embodiment of a method performing a real-time Flourecein sodium cornea staining examination using real-time tele-imaging via remote administration tool, emulating software, screen share, screen control, and screen mirror software via the internet network or network. With iris copes camera, that has cobalt blue filter. Where the iris copes can be installed into a head-mounted apparatus in order for the (assistant or technician) and eye doctor to achieve a binocular view of external ocular images.

FIG. 8 —Illustrate pictorial diagram embodiment of method to perform a remote slit-lamp evaluation via the slit lamps first computer adapted to the (MCB) secondary computer where a remote or distance eye doctor can view the images, videos and can control the slit-lamp robotic adapted parts to view ocular adnexa health of the patient both eyes. Wherewith the robotic adapted slit-lamp eye doctor can control slit, magnification, angles, filters, and angles.

FIG. 9 —Illustrate pictorial diagram embodiment of an (assistant or technician) in a remote medical facility retaking retinal images while eye remote eye doctor view, control, and types patient data from examination to the EMR from his portable electronic device via real-time remote administration tool, emulating software, screen share, screen control, and screen mirror software via any internet network or network.

FIG. 10 —Illustrate pictorial diagram embodiment of a head-mounted apparatus adapted to two iris-copes system relaying images to the (MCB) secondary computer where remote health care provider or eye doctor can visualize fine details such as eye movements when testing for extra-ocular motor function and pupil size when testing for pupillary reflexes. To detect strabismus, disorders of the eyelids, conjunctival disorders via real-time remote administration tool, emulating software, screen share, screen control, screen record, and screen mirror software via the wireless or non-wireless internet network or network. Where the video audio call can be screen mirrored from the smartphone to a smart television.

FIG. 11 —Illustrate pictorial diagram embodiment of a patient is holding a modified iris-cope with filters or no filters where the images are sent to a secondary computer (MCB) where the (remote eye doctor or controller) is connected via real-time remote administration tool, emulating software, screen share, screen control, and screen mirror softwares via the internet network or network. Where the remote eye doctor can control the softwares that control the lighting filters and zoom mechanism of the iris-cope. Where the interconnection control and view is from remote eye doctor electronic device to view, document, record and take pictures to diagnose disorders of the eyelids, conjunctival disorders and external ocular structures of the eye.

FIG. 12 —Illustrate pictorial diagram embodiment of a sample set of fluorescein staining technique, where the technician or assistant instills one drop of fluorescein sodium dye to patient both eyes. Where the patient eyes can be examined, viewed and recorded if cornea damages are seen or if no cornea damage are seen via iris cope, iris cope headset apparatus, slit-lamp. Where the eye doctor is connected via smartphone and screen mirrored to office smart television. Where the eye doctor can view the images saved on the (MCB) of patient cornea and conjunctival damage with and without fluorescein staining dye and with without cobalt picture via real time remote administration tool, emulating softwares, screen share, screen control and screen mirror softwares via a the internet network or network using his portable or non portable electronic device. Where the first one image from top to bottom are fluorescein staining of the cornea via a cobalt blue filter, the top first one is superior punctate keratitis, second is staying skating rink core abrasion caused by possible trapped foreign body trapped under the upper eyelid, third is staining foreign body material metal, wood, plastic or glass in the cornea, and fourth is staying corneal abrasion or laceration.

FIG. 13 —Illustrate pictorial diagram embodiment of an iris-cope with its part and its lights, cup assembly and a portable digital slit-lamp with a robotic adapter configured for remote control software to control slit lamps parts. Where an eye doctor in a remote location can con both device simultaneously via control of the (MCB) second computer using tele-imaging control software via remote administration tool, emulating softwares, screen share, screen control and screen mirror softwares via a the internet network or network. Where the eye doctor can control via his electronic device magnification or zoom of the iris cope, cobalt blue filter lights, white light intensity, slit, and angle. Where the eye doctor can take picture, record images via the software or while viewing real-time.

FIG. 14 —Illustrate pictorial diagram embodiment a (Assistant or technician) taking ocular pressure via a portable handheld ocular pressure tonometer. Where the pressure are inputed by the doctor via his his electronic device (smartphone). Where the (Assistant or technician) can also input the information in the electronic medical record on the (MCB). Where the remote eye doctor on a video audio call with the remote facility smartphone at the same time.

FIG. 15 —Illustrate pictorial diagram embodiment of a (remote eye doctor or controller) portable electronic device (smartphone) connected to the (MCB) via the mobile application, program, or website. Where the remote eye doctor can view, and control the electronic medical record, review, input information, fill out results, fill out diagnosis, plan treatment and sign electronically. Where the application can has the call video conference window open and the geolocation and phone number of the remote medical facility the eye doctor is providing service.

FIG. 16 —Illustrate pictorial diagram embodiment Illustrates a remote eye doctor or controller's portable electronic device running the mobile application where the eye doctor is filling out an electronic prescription for a patient, filling out name, date, NPI, License number, expiration date, and signing with an electronic signature. Where in case of using blockchain technology prescription systems, a transaction hash will be displayed on the bottom.

FIG. 17 —Illustrate pictorial diagram embodiment of a (remote eye doctor or controller) providing service to a remote medical facility via the mobile application, program and/or website. The eye doctor is connected to the network and established a video audio call where the eye doctor is connected to the (MCB) main control unit via remote administration tool technology, screen share, and screen control. Where after receiving service, the patient can pay the remote facility directly or via health insurance. Where the eye doctor may receive payment for the service he rendered by the remote medical facility via the application, program or website.

FIG. 18 —Illustrate pictorial diagram embodiment of an (MCB) main control base computer system with adapter apparatus and an emulating software connection. Where the (MCB) is connected wirelessly to multiple eye examination equipment and is able to view all user interfaces of all equipment connected ocular image software, slit-lamp control, lice slit lamp or iris cope video, payment checkout system, and its Electronic medical record system, where a remote eye doctor portable electronic device (smartphone) can connect via the network (LAN, wireless or non-wireless network) to view and control the (MCB) via remote administration tool, screen share, screen mirror, and screen control.

FIG. 19 —Illustrate pictorial diagram embodiment of a group of eye doctors types of third computer systems or controllers portable electronic devices that can run the mobile application, program or website application to connect to at least one (MCB) that is connected to ocular or medical equipment. Where the eye doctor portable electronic devices can be Virtual reality headset, smartwatch, augmented reality headset, Laptop, smartphone. Where any of the equipment may run an operating system that can be Windows, apple, android, Linux or any other operating system. Where the connection of the remote eye doctor or controllers portable electronic device is using internet to connect to the (MCB) via a combination of softwares. Where the (MCB) main control base or secondary computer system can be tablet, Laptop, smartphone or personal computer. Where the (MCB) or secondary computer system can be of any operating system windows, apple, android, linux, chrome OS, raspberry pi os or any other operating system. Where the (MCB) adapter apparatus and softwares are connected to the ocular exam medical equipment first computer that is connected to the eye examination equipment. Where the (MCB) is connected via an Internet network or local area network to the remote eye doctor or controllers portable electronic device. Where a patient is at the remote medical facility waiting to be seen by the assistant or technician.

FIG. 20 —Illustrate pictorial diagram embodiment of an (EMR) electronic medical record running on the main control base or second computer system user interface. Where (MCB) user interface, it is viewed, controlled and edited by a remote eye doctor or controllers portable electronic device (smartphone). Where the eye doctor can view, control and edit the electronic medical record system remotely and sign remotely, save documents remotely via mobile application with remote administration tool, screen view, screen mirror, and screen control.

FIG. 21 —Illustrate pictorial diagram embodiment Illustrates a network of remote medical facilities all over the world that can be connected to remote eye doctors or controllers anywhere in the world. Where remote eye doctor can schedule date, time and location to provide service via the mobile application, program or website via the network. Where the remote medical facility may or may not have all its equipment connected to the (MCB) via multiple tree topology system configuration to reduce lag and speed up transmission time.

FIG. 22 —Illustrate pictorial diagram embodiment Illustrates a patient in a remote medical facility viewing a remote vision acuity chart on a computer system. Where the remote vision chart is connected to the (MCB) via adapter, infrared, bluetooth, wifi, LAN or any wired or non wired configuration. Where a (remote eye doctor or controller) can control the vision chart via the (MCB), while established video audio call to the patient via the remote facility smartphone.

FIG. 23 —Illustrate pictorial diagram embodiment Illustrates a way to connect the systems via multi-topology and multi-tree topology configuration using a wired or wireless connection to establish a low latency, low lag, and using wire, proprietary adapter apparatus, and proprietary emulating software. Where at least one (MCB) main control base or secondary computer base can control multiple equipment concurrently via the network topological connections via special softwares, adapter apparatus, emulating software, remote administration tool technology, emulating software, screen share, screen control, and/or screen mirror. While the eye doctor or controller third computer system or portable electronic device can control via the network, the (MCB) main control base user interfaces indirectly controlling all medical equipment while still being able to access cloud storage, files sharing system and/or IPFS to control, view, review and edit all patient medical data. Where the eye docs can provide indirect to direct visual acuity examination, near distance subjective refractions, external ocular health examinations, retinal examination, and can control the electronic medical record in at least one (MCB).

FIG. 24 —Illustrate pictorial diagram embodiment Illustrates via the topological connection used to connect the medical or eye examination equipment embedded system or non-embedded system computer system called the first computer. Where the first computer can control the equipment directly. Where the first computer is connected to a secondary computer system called the (MCB) or secondary computer system. Where at least one first computer is connected to the (MCB) via emulating softwares and other types softwares. Where the first computer user interface is emulated to second computer interface. Where at least one or more first computers can be connected by the second computer (MCB) system. Where a third computer system or remote eye doctors portable electronic device can control the second computer to indirectly control the first computers that control the eye examination equipment, robotics or its parts. Where each (MCB) base can control multiple equipments via the network topological connections via a network and where the (remote eye doctor or controller) with a third computer system or portable electronic device can control via direct means the first computer systems of the equipment via direct connection means via a switch mechanism to perform the same task indirect instead of indirect technique.

DETAILED DESCRIPTION

A secured (IDD) indirect to direct or direct on-demand doctor to patient telemedicine remote ocular health examination system. Where the indirect to direct on-demand connection can be switched to direct connection in some cases or situations. This service system allows telemedicine ocular health examination to be made via an ocular examination equipment kit (OEK), mobile applications, emulating software, an adapter apparatus, multiple software, and/or remote administration tool technology. (FIG. 4 ). The ocular examination kits can be assembled in any location schools, emergency rooms, clinics, mobile clinics, military bases, aircraft carriers, or any mobile or non-mobile location. (FIG. 4 ) (FIG. 20 ).

In some cases, the addition of a portable digital phoropter or subjective refractor apparatus can also be connected to the system to provide Indirect to direct subjective refraction service via mobile app. The ocular examination equipment kit can be installed inside rooms, offices, mobile trailers, mobile exam rooms, kiosks, booths, anywhere in the world. (FIG. 20 ). The ocular examination equipment kit contains two portable computers but may include more computers in the future. One of the portable computers which together with the OS, interface, adapter apparatus (AA), proprietary emulator software, connection to the equipment and software that will be called the (MCB) for main control base. (FIG. 4 ; 15).

The ocular examination equipment kit (OEK) contains a MCB, wireless cellphone router, smartphone, slit-lamp, two iris-copes, non mydriatic retinal camera, multiple USB connectors, and a head-mount ocular examination apparatus (FIG. 4 ; 23,24,25,22,20,23,26,17,16,18). The ocular examination kit can also include future upgrading to provide digital phoropter or (subjective refractors apparatus), lens-meters, and auto refractor systems to be connected to the MCB. In some cases, in the future, one or more MCB may or may not be added to the systems. The current system has portable computers (MCB) that run multiple software including remote doctor scheduling software, machine learning software, emulating software, electronic medical record software, remote administration tools (RAT) software, and multiple ocular cameras control software. All doctors in the on-demand service network may sign up to the mobile application and run a mobile application on their personal electronic device (smartphone, tablet, smartwatch, or laptop). (FIG. 2 ; 1,2,3,4,5,6,7) (FIG. 3 ).

The mobile application can be a running a mobile app that can vary depending on operating systems. The mobile application can also be a DAPP decentralized application running on a blockchain system. This mobile application facilitates connection to the remote facility designated for the location, day, and time they will provide service and payment for medical service rendered. (FIG. 3 ; 67,55,8,9,10,49,68). Each remote medical facility with their (OEK) will include a user name and password for the on-demand eye doctor to provide service on the day and time the service will be rendered. (FIG. 20 ; 55,30,56). Payment to the eye doctor can be sent via the mobile application from the remote medical facility to the eye doctor or, in some cases, direct payment from the patient to the eye doctor. (FIG. 17 ; 58).

The payment can be made to the eye doctor via credit card, cryptocurrency, or any other type of payment method. An assistant will be at the remote location and will set up the ocular examination equipment Kit (OEK) and connect online. (FIG. 5 ; 31). The assistant may be a (nurse doctor, optometric technician, ophthalmic technician, or any health care provider). (31). The assistant will help with the connection to the mobile application and help with the connection to the on-demand eye doctor. (FIG. 5 ; 31, 21,50,49,2,29,30,1,50,31,30,27). In cases of the same day on demand service, the request can be from facility to eye doctor or from eye doctor to facility depending on the application setting used. (FIG. 3 ; 67)(FIG. 20 ; 55,30,56).

The remote eye doctor will be able to control the portable computer (MCB) without having to be in the exam room. The exam room can be in a mobile location or a non-mobile location. (FIG. 5 )(FIG. 6 ; 30,29,15). The system interconnection is made by remote administration tools software application technology via the internet using ethernet, cellphone wireless networks, or wifi. (29). The interconnection of the on-demand eye doctor and the remote medical facility (RMF) will be delegated to the mobile application, a decentralized application (DAPP), or website similar to Uber or Lyft where the eye doctor can provide telemedicine ocular health examinations service to multiple locations in the world depending on the selection on their mobile application, DAPP or website. (FIG. 2 ; 2). The medical equipment (digital slit-lamp, digital iris-cope, digital retinal camera) is controlled directly by the portable computer (MCB) in the exam room via a wired or non wired connection. (FIG. 5 ; 16,19,17,22,26,14,15). The portable computer (MCB) will run software that controls software that controls the medical equipment. (FIG. 12 ; 39).

The portable computer (MCB) will also have a remote administration tool technology software or application installed into its main operating system. (FIG. 18 ; 12,15). The portable computer (MCB) may also have the ability to use a browser as a (Remote connection to the eye doctor). The possibility of using a browser with a (remote connection) can be facilitated with a secondary commercial or non-commercial company if needed. The portable computer (MCB) can be of any operating system Android, windows, or Linux depending on the computer used with its interface software. (FIG. 18 ; 15,69). The eye doctor can have any portable electronic device (smartphone, tablet, laptop) with any operating system Android, Windows, or Linux with a mobile application. (FIG. 2 ; 1).

The mobile application will be used to connect to a remote medical facility (RMF) with the portable computer (MCB) that runs (RAT) software technology. (FIG. 21 ). The portable computer (MCB) has to have the remote administration tool technology application, adapter apparatus, emulator software, ocular control software running at the same time to be controlled by a remote eye doctor from anywhere in the world. (FIG. 18 ; 11,52,51,39,12,54,53,15,69). The eye doctor needs to have the mobile application running on his portable electronic device. This application may have remote administration tool technology capabilities that can be used to interconnect to the remote medical facility (RMF). (FIG. 2 ; 1,2). The eye doctor will receive a text message with the user name and password to interconnect to the remote medical facility portable computer (MCB). (FIG. 3 ; 1,67,55).

The main purpose of the portable computer (MCB) is direct control of the electronic medical records software, ocular camera software, or any other medical equipment via wired connection, but via a remote administration tool software, it can be controlled by an eye doctor providing service. (FIG. 5 ) (FIG. 18 ). The (MCB) with adapter can also be connected to any eye examination equipment from any maker in any optometric or ophthalmology office. The portable computer (MCB) will always be connected to the internet via ethernet, wifi, or any cellphone wireless network. In the event that the remote medical facility (RMF) does not have its own internet service, the ocular examination equipment Kit (OEK) also comes with a wireless cellphone network internet router to provide an internet connection to the system. (FIG. 4 ; 20,21,15,69). The person connecting to provide service can be an (optometrist, ophthalmologist, or any other health care provider) with a portable electronic device (VR headset, AR headset, smartphone, smartwatch, laptop, and/or tablet) running the mobile application. (FIG. 2 ; 1). The eye doctor or health care practitioner's portable electronic device (PED) can be a smartphone, smartwatch, tablet and/or laptop.

The main control base computer can be remote-controlled over Internet protocol networks using an applet running on the communication device, and the eye doctor (PED) can control the exam room (MCB) portable computer by using a (RAT) applet running on their portable electronic device (smartphone, tablet, laptop, VR headset, smartwatch and/or AR headset). The remote administration tool technology can interconnect between any type of computer independent of the operating system. (FIG. 19 ). When the assistant or mobile application sends a text message or message via the app to request an on-demand (eye doctor), he or she can accept or decline the request for (RAT) interconnection. In some cases, the mobile application can also work by having the eye doctor look for a location on the mobile application to provide service similar to Airbnb, Uber, or Lyft. If and when the eye doctor accepts the request, they have to insert a user name and password via the remote administration tool software.

The (RAT) remotes administration program installed within its system may randomly generate a user name and password authentication for the (eye doctor or controller) to be able to log in and connect to the portable computer. The remote medical facility can also delegate a username and password for the remote eye doctor to connect to the system if needed. This random user name and password facilitate a secure connection to any eye doctor scheduled or that accepts to become a supported controller to provide service with their portable electronic device. By way of indirect to direct connection, the eye doctor can control the exam room portable computer (MCB), which will directly control the ocular health cameras software that may be running software that controls the EMR, retinal camera, iris copes, or digital slit-lamp. In the case of a robotic digital slit lamp, the parts can be controlled remotely also. (FIG. 23 ).

The eye doctor can control indirectly remotely operate the digital ocular cameras and digital slit-lamp remotely to refine images and videos for a proper remote ocular examination from a patient at the office. Adapters on the digital slit-lamp can be added to facilitate the remote control of the slit control, click stop, filters, magnification changer, and joystick elevation knob. Some portable or non-portable slit lamps may already come with built-in robotic or electronic control of all: slit control, illumination arm, click stop, filters, magnification changer, and joystick elevation knob. In any case, the control system can be connected via an adapter apparatus, emulating software, or run via OS—compatible control software via the MCB to have complete control remotely by a remote eye doctor providing service. The eye doctor that is connected to the system will be able to control the iris copes and slit-lamps to gather video or pictures of the patient's ocular health of the anterior segment of the eye. In some cases, the eye doctor may switch from the indirect to direct to (direct to direct) connection method to get a better connection.

In some cases of unstable connection, the eye doctor can instruct the assistant to control and take the images or videos of the anterior segment of the eye via the iriscope and slit lamps systems. The patient eyes can be tested for a number of conditions using the different lights and magnification on the ocular cameras. The remote (eye doctor or controller) can review the ocular retinal pictures and zoom in and out to analyze via a cloud storage system or via the memory built-in into the camera's computers. If and when the connection is optimal, the eye doctor can review the images realtime via the system. In realtime viewing and control of the iriscope and slit lamps, the remote doctor can control the lights and filters of the slit-lamp and or the iriscope contraption. The filters used in both eye iris copes contraption, and slit lamps are cobalt blue filters, green, red-free filters, and neutral density filters.

Any of these filters will be used for diagnosis purposes. The iris copes, and slit lamp will be used to evaluate the health of the anterior segment of the eye as far posterior as the anterior portion of the aqueous humor. The eye doctor or the assistant can vary the angle of illumination arm, magnification, and type of slit beams via manual or remote means using the software running inside the MCB. The option of the type of slit lamps beams may be from diffused, wide parallelepiped, narrow parallelepiped optic section corneal beam wide parallelepiped narrow parallelepiped to view the appropriate ocular structures. As part of the examination, the assistant at the remote office may instill fluorescein sodium on the patients eye and the remote doctor or assistant may view or control the lighting and filters on the digital slit-lamp and iris cope with determining anomalies in the cornea or conjunctival tissue.

The eye doctor may also control the digital slit lamp, and iris copes realtime during the examination if needed. The controller of the iriscope or slit-lamp will take image photos or videos to review but can also be review by the doctor realtime. During the iriscope and slit-lamp examination, the anterior segment of the eye will be examined by the assistant, including: Lids, lashes, cornea, conjunctiva, and anterior chamber. In the event of no cornea problems, the remote doctor may instruct the assistant to perform ocular pressure tonometry on a patient to view intraocular pressure results. (FIG. 14 ). The ocular pressure tonometry may be transmitted automatically to the portable computer (MBC) interface and can be viewed by the eye doctor remotely via the remote administration tool interconnection. (FIG. 14 ).

In the case of an unstable connection, the assistant can take the tonometry reading and type the results to the EMR software or send the results to the eye doctor via text. (FIG. 20 ). At the end of the remote telemedicine remote control connection, the remote eye doctor may prescribe proper medications for the ocular conditions via the mobile application or via a prescription via email. All information may be edited by the remote eye doctor as they will have access to the electronic medical record (EMR) at the exam office portable computers system via remote control and remote sharing technology. (FIG. 15 ). The on-demand Optometrist or Ophthalmologist (eye doctor) anywhere in the world can perform the ocular examinations remotely and can communicate with the patient via HIPAA compliant encrypted video and voice or voice call. The video audio or audio call can be done via the remote medical facility smartphone in the (OEK).

The support controller (eye doctor) can also use portable wireless headphones with a microphone to maintain clear communication with the patient. The Optometrist or Ophthalmologist (eye doctor) will ask the patient if the patient has any questions. Payment to the remote eye doctor may be made via the mobile application or via a contract with the remote facility company. Payment can also be made via connection to a mobile application on the patient's smartphone or portable electronic device. (FIG. 17 ). The eye doctor can send out a prescription via picture or email to the eye exam office, pharmacy, or to the patient's email. (FIG. 16 ).

The system will be operated by a network of healthcare providers with the application running on their portable electronic devices. The mobile application has the capabilities to have a scheduling system for each remote medical facility needing service. The system is built to be upgradable to provide extra equipment adaptability. Some of the equipment adaptability may be any digital phoropter and/or subjective refractor apparatus from any company. With a proprietary special proprietary adapter apparatus and software, any system or equipment can become remotely controlled by the network of healthcare providers. In the case of the digital phoropter or any portable digital phoropter technology, a remote healthcare provider may be able to control the robotic equipment inside the phoropter that changes the lenses that changes the shape of the lenses depending on the digital phoropter technology used. (FIG. 23 ).

No matter which vision refraction system is used, the ability of the adapter apparatus being and software being connected to the device becomes an (IDD) indirectly to directly direct or an indirect to direct (ID) remotely operated via MCB. This will enable any remote health care practitioner to provide remote subjective refraction to any person in the world. The way the system is configured with the proprietary adapters makes it capable of being operated anywhere in the world as long as we have internet connectivity and wireless cellphone networks connectivity. (FIG. 24 ). 

What is claimed is:
 1. The present disclosure relates to a clinical workflow, method, system, and apparatus comprising means for using a proprietary adapter apparatus to modify any portable or non portable eye examination equipment to perform real time tele imaging eye examination with remote control capabilities to plurality of equipment in a remote location. Where we used a selected group of eye examination equipment within a portable equipment kit to be enhanced via an adapters apparatus, software, and robotics adapters to have an internet connection, remote administration tool software, screen share, screen mirror, screen control, remote robotic control, and telemedicine capabilities. The improvement aid in the means for allowing any medical or eye equipment system to be remotely controlled independent of time and space using any equipment adapted via adapter to any secondary computer system or processor with remote administration tool (RAT) technology, emulation software, screen share, screen mirror, and screen control to aid means for remote-controlled internet connection from a distant eye doctor, health care practitioners, or technicians anywhere in the world to provide medical and eye examinations via ethernet, wifi, or any cellular wireless network 4G, 5G, 6G or better. At least one examination equipment with embedded system and/or embedded processor where medical or eye examination equipment with an embedded system and embedded processor with its input/output peripheral devices and dedicated function will be called the first computer system. As the first computer system connecting to at least one secondary computer system called the MCB. The equipment houses a first computer system composed of a processor, memory, system software, source code, and operating systems with its user interface equipment control software. The user interfaces software aids in the viewing and controlling of the medical or eye examination equipment or apparatus. The medical or eye examination equipment with its processor may be of any maker, company, or model as long as it can be connected to a secondary computer system via proprietary adapter apparatus, proprietary software, and remote administration tool technology to interconnect both systems. An at least one (second computer system) with processors memory, system software, source code, and operating system called the main control base (MCB) configure to run at least one medical electronic medical record system, medical image software, and remote administration tool application (RAT), emulating software running on its operating system, cause the adapter apparatus to emulate at least: first computer system medical examination machine, robot, instrument, equipment, device or apparatus control user interface, operating system, while still being able to run multiple other software, multi-screen mirror, multi emulator software for other systems, human-machine interface software, kiosk software, cross-platform software, emulators, screen mirror, screen share software to aid in the controlled connection to operating systems and software of at least one equipment first computer system and its operating systems. At least one mobile application installed in a plurality of (controller or remote eye doctor) third computer system device, first computer system and/or secondary computer system (MCB). The remote administration tool, screen share, screen control software may be executed via a computer program, software, web application, mobile web browsers, or browser; The smartphone computer programs and/or Web conferencing program, can run via the smartphone and/or the secondary computer system, independent phone system voice-video call, or via mobile web browsers (controller or remote eye doctor) that is HIPPA compliant. At least one or more computer systems are connected to the internet. Where mobile broadband hotspot modem routers may connect all processors and/or computer systems on a remote medical facility to the internet network, if the facility used does not have ethernet, wifi, and/or cellphone wireless networks or more advanced cellular wireless networks to establish interconnection to computer systems processors with controllers processor; Receiving, navigating, viewing, and selecting, from controller software user interface a network of remote medical facility devices with adapted examination machine to MCB software, instrument, equipment, device or apparatus, a request to schedule a (controller or remote eye doctor) to perform service in particular geolocation, time zone, type of services, time and date via controllers eye doctors third computer system or portable electronic device; Receiving, navigating, viewing, and selecting, from MCB processor software user interface running on a remote facility device, a list of health care providers signed up or logged in to the mobile application. Where the signing up of the mobile application, program or website requires information from he health are provider: name, health care providers license numbers from each state or country, nation provider identification number (NPI), type of health care provider, cellphone number, and way to receive payment for service. Where remote facility can request doctors to schedule a remote administration connection and audio/video appointment with a (controller or remote eye doctor) or health care professional in particular geolocation, time zone, type of services, time and date via electronic message and/or application; Initiating a plurality of first processors, second processors, and third processors of at least one computer system memory including source code software; Where in at least one first processors, memory, system software and source code are configured to control equipment from the same location or distant location: and its user interface parts are to emulated to at least a secondary processor, memory, system software, and source code where It can be remotely controlled from the same location or distant location by a controller providing service with a third processor. Whereat one least secondary processor, memory, system software, and source code can be controlled viewed, controlled remotely via a controller health care provider with a third and/or secondary processor, memory, system software, and source code from the same location or distant location: Receiving, from at least one first processor and/or first computer system on a remote facility, a request interconnection to second computer systems devices via at least one adapter apparatus, software, remote administration tool technology, emulating software, screen share, screen control, and/or screen mirror software at the same location or distant and/or remote location; Receiving, from a secondary computer system softwares and device running on a remote facility technician device, a request to schedule a remote administration tool connection and audio/video appointment with a (controller or remote eye doctor) health care professional with a third computer system running operating system, with softwares, remote administration tool technology, emulating softwares, screen share, screen control, and/or screen mirror software at the same location or distant and/or remote location; Sending and/or receiving, from secondary computer system MCB applications toward a controller or healthcare professional mobile software running a healthcare professional user at least one device of the healthcare professional, an indication of the request to schedule the real-time or near-real-time remote administration tool interconnection, software, emulating software, screen share, screen control, screen mirror software and/or audio/video appointment interconnection at the same location or distant and/or remote location; Receiving, from the (controller or remote eye doctor) and a third processor or third computer system with the mobile program, an indication of an acceptance of the request to schedule the remote administration tool interconnection, software, emulating softwares, screen share, screen control, screen mirror software and/or audio/video appointment with the healthcare professional to provide medical or eye examination service to patients at the same location or distant and/or remote location; Facilitating a remote user interface control via remote screen sharing and remote administration tool technology and audio/video call between the healthcare professional controller third computer system device with the patient positioned on the medical or eye examination machine, robot, instrument, equipment, device or apparatus controlled by the second computer system device that controls the first computer system that controls medical equipment or apparatus; which a technician positions patient onto examining equipment with a remote health care professional controller via realtime or near-realtime to examine patients medical, ocular, eyeglass prescription, vision acuity with a remote viewer and controller at the same location or distant and/or remote location; Controlling, navigating, selecting, and administering via MCB, eye examination via remote administration tool technology, and managing emulated user interface of equipment softwares, electronic medical records, and all electronic, robotic control equipment software emulated on to the main control base at the same location or distant and/or remote location; Controlling, navigating, selecting, and gathering medical examination equipment user interface via remote administration tool technology to provide medical and ocular health examinations, vision examination, objective and subjective refractions via indirect to direct and/or direct to direct connection to computer systems and medical or eye examination equipment with computer systems running viewing and control all equipment at the same location or distant and/or remote location. Controlling, navigating, selecting and recording, via remote administration tool technology, screen mirror, screen mirror recording, screen share, screen control technology toward the healthcare professional via at least one device running application, the medical examination images, data, information associated with the patient at the same location or distant and/or remote location; Controlling, Sending, and recording, toward the (controller or remote eye doctor) healthcare professional application or program user interface, additional medical information associated with the patient via remote administration tool technology, screen share, screen mirroring, and screen control; and Receive, control, and record, from the (controller or remote eye doctor) healthcare professional application or program to the second computer system (MCB) information related to diagnosis of the patient at the same location or distant and/or remote location. Reviewing, diagnosing, controlling, recording, and sending, from the remote administration tool technology, screen mirror, and file-sharing system information related to medical prescriptions, or glasses or contact lenses prescriptions of the patient by the healthcare professional (controller or remote eye doctor) at the same location or distant and/or remote location.
 2. The method, system, and apparatus of claim 1, wherein at least at least one medical or eye examination equipment coupled to a processor connected to adapter may be built-in personal computer systems or the personal computer system connected to the medical and eye examination device, machines, robotics, equipment, instrument or apparatus with its user interface control software. Where first computer system may be of any operating system or embedded system, windows, IOS, Linux, and/or Chrome OS. The proprietary adapter apparatus works as an enhanced communication unit to the medical or eye examination equipment processor, which can be controlled by a secondary computer system to aid in the improvement to provide remote, screen mirroring, and screen control of a first computer system user interface, software and system to the second computer system user interface called the main control base MCB. The first and second computer system may control at least one of the parts of any medical or eye examination equipment such as parts, mechanical structures, locomotion system/manipulators, lens holders, spherical diameter regulators, base curve of lenses, prisms, wheels, belts and pulleys, springs, gears, lights, end effector, pinholes, cylinder lenses, powered lenses, liquid lens module, digital micro-motors, Lenses, lens wheel, electric current regulators, variable focus liquid Lens, liquid lens actuators, Phoropter Liquid Lens, Liquid Lens refraction unit, auxiliary lens wheels, automatic holographic adaptive phoropter, lens glass, focus, aperture controls, shutter mechanisms, cylinder accessibly, a mechanism that switches lenses, rotors, index of refraction regulators, regulators, pressure flow regulators, liquid, spheroidal shapeshifters apparatus, cameras, zooming device, transmissions, actuators, servo motors, sensors, controller mechanisms and all other parts of any of the medical, optometric, eye examination device or robotic interfaces. Where the first computer system will be connected, controlled, emulated, screen mirrored, screen imaged, screen controlled to a secondary computer system via an adapter. The adapter apparatus and software attached to the first and second computer system also have their power supply units and external output/input adapter apparatus connected to a secondary computer system (MCB) via adapter, dongle, local area networks, wide area networks, USB cable, wifi, USB, wifi, bluetooth, satellite area network, satellite Internet access or any other wired or non-wireless connection or any computer system. The connection all to facility the screen mirroring, remote screen control of the secondary computer system to the first computer system and its equipment. The third computer system where the connection from first computer system to the second computer system may be via a type of remote administration tool technology and other software to aid in interconnection, and first computer system to the third computer system may be via remote administration tool technology and other software to aid connection.
 3. The method, system, and apparatus of claim 1, wherein at least one first computer system and adapter apparatus and software interconnection is done via multiple types of topology configuration connection with adapters and software on medical examination machine, instrument, equipment, robotics, device or apparatus first computer systems, and (MCB) second computer system. Where one or more medical and optometric equipment with its first computer systems are adapted to at least one or more secondary computer systems (MCB). Where the use of multiple types of topology configuration connections and also multi tree topology configuration reduce lag and speed up transmission time. Where multiple first computer system user interfaces and multiple screen mirrors and screen control can be emulated or mirrored onto the secondary computer system simultaneously. Where controller with any third computer system running an application controlling all multi-screen and multi controls real-time or near-realtime to perform a medical or eye examination remotely using wireless or non-wireless internet connection, TCP/IP or on a (LAN) local area network LAN.
 4. The method, system, and apparatus of claim 1, wherein at least one mobile application running remote administration tool technology is installed onto the second computer system called the main control base (MCB) and its connection to the Internet connection, TCP/IP or on a local area network LAN and runs multiple software, compatibility layer interfaces, emulating software, screen mirror, screen share, remote human-telemedicine robotic user interface software, and/or screen control software. Emulating at least one of first computer systems entire user interface onto second computer system user interface simultaneously and emulating via remote administration tool technology entire second computer system user interface onto third computer system interface via a mobile application or software to provide indirect to direct and/or direct to direct connection via internet wireless and non-wireless remote administration tool connection to a (controller or remote eye doctor) or remote health care provider with a third computer system device running a remote administration tool technology software to control the (MCB) that controls the first computer system equipment control software. Where additional or alternative connections can also be made via network body (BAN), (WBAN), Personal (PAN), Near-me (NAN), Local (LAN), Campus (CAN), Backbone, Metropolitan (MAN), Municipal wireless (MWN), Wide (WAN), Cloud (IAN), Internet or InterPlanetary File System (IPFS).
 5. The method, system, and apparatus of claim 1, wherein At least one or more mobile broadband hotspot modem routers where all processors and/or computer systems on the remote medical facility can connect use hotspot wifi to connect to the internet network. Where at least one mobile broadband hotspot can be used to connect one or more second computer systems MCB with its first computer system and medical or eye examination equipment connections. Where internet connection can also be achieved via ethernet, wifi, and/or cellphone wireless networks at the remote facility location. Where the remote facility can be anywhere in the world to provide service as long as there is an internet connection. Where VSAT or Starlink satellite internet can also be used to achieve internet connection to interconnect medical equipment and eye examination equipment via remote administration tool technology software;
 6. The method, system, and apparatus of claim 1, wherein; wherein Receiving, navigating, viewing and selecting, from controller software user interface a network of remote medical facility to provide service comprising: Where a receiving or selecting to schedule a (controller or remote eye doctor) to perform service in particular geolocation, time zone, type of services, time and date via controllers eye doctors third computer system or portable electronic device where a controller can connect via three forms of connection; A controller of at least one first computer system with user interface software to control at least one equipment via source code commands, user interface and graphical user interface software to control the optometric or medical equipment and its parts to perform a medical examination or eye examination at the same location of the first computer or from a distant location from the first computer system (direct control). A controller of at least one second computer system connected to a first computer system. Where first computer system with user interface software is transmitted emulated onto second computer system user interface. Where second computer system controls at least one first computer system to control at least one optometric or medical equipment via remote administration tool technology, emulation software, screen viewing, screen share, screen mirror, and screen control softwares to perform a medical or eye examination using wifi, bluetooth, cellular wireless networks, CWN 4G, 5G, 6G or greater, Internet connection, TCP/IP or on a Local area network LAN connection. Where controller of the system is at the same location of the first computer or from a distant location from a second computer system (direct to direct control). A controller of a third computer system device running software to control the second computer system that control a plurality of first computer system connected to one or a plurality medical or optometric equipment to control all graphical user interface and a plurality of control softwares simultaneously via at least one remote administration tool, emulation, screen share, screen mirror and screen control softwares on at least one or more devices to perform a medical examination or eye examination with wireless or non wireless Internet connection, TCP/IP or on a Local area network LAN connection. Where the multi equipment controller of the system is at the same location of the second computer or from a distant location from a second computer system with a third computer system (indirect to direct control).
 7. The method, system, and apparatus of claim 6, wherein; wherein multiple forms of connection to control the medical and eye examination equipment comprising: Where in indirect to direct control one or more secondary computer systems can be at the same location or distant and/or remote locations from one or more first computer systems, and each individual of a plurality of first computer systems are at the same location as the medical equipment, instruments and its parts while a patient is being examined, and positioned on to the medical equipment for examination or evaluations by a remote or physical technician. At least one or more remote controller with third computer systems can control the at least one or more second computer system that controls the user interface software to control at least one or more first computer system and equipment user interface via indirect to direct connection as long as they have internet connection remote administration tool technology software running on both second and third computer system device operating systems. Where at least one or more remote controllers third computer system user interface may be a portable computer system device such as smartphone, virtual reality headset, smartwatch, augmented reality headset, personal computer system, laptop, tablet with any user interface and any other device to control via real time or near realtime the examination equipment and its parts to perform real or near realtime medical health examination, ocular health examination, diagnosis, treatments, screening, subjective refraction, objective refractions, pupillary distance measurement, retinal photographies, ocular external health photographies, keratometry, visual field testings, visual acuities, color vision screenings, ocular muscle movement testing, pupillary reaction testing, near subjective and objective refractions, minor surgeries, cornea flourecein staining evaluations, tear break up times evaluations, prescription extensions, medication prescriptions, retinal scans, lensometry reading, contact lens fittings, corneal topographies, and any other ocular or medical examination.
 8. The method and system of claim 1, wherein the indication of the request to schedule the remote administration tool interconnection, screen viewing, screen share, screen mirror, screen control and audio-video appointment with the (controller or remote eye doctor) health care professional includes symptoms information of the patient and payment information of the patient. Where symptoms information is documented by a technician at the remote site on to the main control base computer system running an (EMR) electronic medical record software and where payment information can be (CBDC) central bank digital currencies, cryptocurrency wallet addresses, stable-coins, cryptocurrency, wire transfer, credit card, pay-pal, e-commerce webpage, or any other payment gateway.
 9. The workflow, method, system, and apparatus of claim 1, wherein at least one memory, medical equipment and processor, connected to the secondary computer system (MCB) are configured to, with at least one processor, cause the mobile application or softwares to at least: Receiving, from the (controller or remote eye doctor) health care professional mobile application before the remote administration tool connection and audio-video call, an electronic message request for patient information affiliated with the patient; and Concluding whether the healthcare professional is approved to access the second computer system (MCB) with patient information associated with the patient; and Sending toward controller health care professional electronic message access password and username of remote administration tool software to healthcare professional to connecting via real-time or near-realtime remote administration tool interconnection, remote screen viewing, screen share, screen mirror, screen control, and audio-video call application based on a decision that the healthcare professional is authorized to access patient information affiliated with the patient.
 10. The workflow, method, system, and apparatus of claim 9, wherein the patient information includes at least one of diagnosis, chief complaint, past eyeglass prescriptions, past contact lens prescriptions, auto-refractor results, keratometry results, ocular pressure results, eye movement video recording, face picture, demographics, phone number, age, medical insurance, vision insurance, medical history information, payment type, geolocation, chief complaint, symptom information, or past medical examination information of the patients. Viewing and controlling via remote administration tool technology, remote screen viewing, screen share, screen mirror, screen control via a secure real-time or near-realtime connection from the controller third computer systems user interface and the remote facility second computer systems (main control bases) and electronic medical records running on at least one MCB.
 11. The method, system, and apparatus of claim 1, wherein at least one memory and the computer system program software are configured to, with at least one processor, cause the secondary computer system MCB to at least: Receiving, from the healthcare professional application, a request for the medical examination information affiliated with the patient; and Sending, toward the second computer system MCB and remote administration connection, a communication indicative of the request for the medical examination information affiliated with the patients; and Sending, toward the second computer system MCB and remote administration connection, a communication indicative of the request for the medical examination information affiliated with the patient. Where the remote administration tool softwares, emulators, remote screen viewing, screen share, screen mirror, screen control softwares can be of commercial or non-commercial means from any maker, model, source code, programming language and can work in any computer system with any operating system or on some operating systems.
 12. The workflow, method, system, and apparatus of claim 1, wherein the electronic messages indicative of the request for medical examination information associated with the patient is configured to cause the connection via remote administration tool softwares, emulators, remote screen viewing, screen share, screen mirror, and screen control softwares to the remote facility main control base computer system to initiate the viewing, controlling and gathering of the medical examination information affiliated with the patient.
 13. The workflow, method, system, and apparatus of claim 1, wherein the message indicative of the request for the medical examination data associated with the patient, is configured to accumulate, review and control several types of medical examination data from similar or different medical fields, medical equipment or eye examination equipment.
 14. The workflow, method, system and apparatus of claim 13, wherein the medical examination data includes realtime or near-realtime viewing via (RAT), emulators, remote screen viewing, screen sharing, screen mirroring, and screen control softwares, recording and controlling of exam results, images and videos of a portion of the interior and exterior parts of both eyes of the patient, video-audio documentation of a portion of the eyes and face of the patient, ocular eye pressure reading of the patient, vision camera of the exam room, auto-refractor results of the patient, objective refraction of the patient, an indirect to direct subjective refraction of the patient, visual field of the patient, direct to direct subjective refraction of the patient both eyes, visual acuities of the patient, and near subjective and objective refraction of the patient all done via indirect to direct or direct to direct connection using remote administration tool connection emulation, realtime or near-realtime screen view and screen control from the eye doctor third computer system to the main control base. All due to having the ability for the eye doctor's third computer system to connect to the first computer system to control or view softwares running on its equipment computer system operating systems.
 15. The workflow, method, system, and apparatus of claim 1, wherein at least one memory and the computer system program software are configured to with at least one processor, and source code cause the emulation of the user interface to second computer system to at least: Receive, from the healthcare professional mobile application, a request to control and view additional medical information; and viewing and controlling the other medical information toward the healthcare professional mobile remote application based on the request for the additional medical information.
 16. The workflow, method, system, and apparatus of claim 1, wherein the additional medical information includes at least one of a thermographic camera of eye and face structures, HRT, auto-refractor results, kerato-meter results, lensmeter results, prior eyeglass or contact lens prescription data, Pachymeter reading, coherent optic tomography, past diagnosis, history past surgeries, subjective refraction measurements, intraocular pressures, blood pressure measurements, objective refraction measurement, eyeglass prescriptions, contact lens brands, contact lens prescriptions, and/or a blood report. Viewing, controlling, administering remotely and/or delegating to a technician via the remote administration tool technology, emulation software, screen share, screen control, or one or more equipment user interface.
 17. The workflow, method, system, and apparatus of claim 1, wherein the information related to medical diagnosis and vision examination diagnosis of the patient by the healthcare professional includes at least one of a diagnosis description to be associated with an account of the patient, medical prescription, eyeglasses prescription, a contact lens prescription or medical referral note.
 18. The workflow, method, system, and apparatus of claim 1, wherein the data related to the examination of the patient by the healthcare professional includes a prescription, wherein at least one memory and the computer system program software are configured with at least one processor, cause the equipment to at least: Registering the user in an electronic prescriptions system that sends there to their favorite pharmacy or optical store. Determining a preferred pharmacy or optical store of the patient; and send the prescription toward a device of the preferred pharmacy or optical shop of the patient. Delegating, utilizing a system of medication, eyeglasses, or contact lens prescription sending and recording that may use blockchain technology prescription network.
 19. A workflow, method, system, and apparatus, comprising: Receiving and viewing, from a remote facility electronic message application running on a second computer system device MCB, a request to schedule a remote administration tool connection, screen share, screen control, screen mirror, and audio/video appointment running on a healthcare professional mobile application; Sending, toward a controller healthcare professional third computer system with mobile application user interface, an indication of the request to schedule the remote administration tool and audio-video appointment with the second computer system or first computer system in the remote medical facility; Receiving, from the controller healthcare professional application, an indication of approval of the request to schedule the remote administration tool, screen share, screen control, screen mirror and audio-video appointment with the second computer system MCB or first computer system with equipment via a technician at the remote medical facility;
 20. The workflow, method, system, and apparatus of claim 1, wherein the plurality of connected medical or eye examination equipment are connected to its first processor or computer systems. Which one or more equipment with processor or computer system are connected to secondary computer system (MCB) via and adapter apparatus and softwares. Where a third computer system or processor from a remote controller anywhere in the world can remotely view and control one or all of the equipment computer system or processor remotely includes at least one of digital retinal camera images, two external ocular iris cope cameras images, head mounted iris cope adapter, iris-cope cobalt blue filter lights images, a digital slit-lamp images, a robotic digital slit-lamp images and videos, slits lamp cobalt blue filter, digital vision chart screen, automatic phoropter user interface, digital phoropter with user interface, variable focus liquid lens phoropter with user interface, auxiliary lens wheels user interface, automatic holographic adaptive phoropter with user interface and controlling software, digital phoropter with user interface computer system controller system, lens-meter with user interface, a portable or non-portable auto-refractor with user interface, ocular pressure tonometer with a user interface also that the remote controller can control via softwares one or more adapters controllers, robotic actuators, servo motor adapters with softwares simultaneously. Where a technician can instill onto patient eye a drop from fluorescein sodium strips or a drop of a bottle of (Flucaine) Proparacaine hydrochloride for the remote controller to evaluate cornea health real-time screen mirror screen control via cobalt blue filter with iris cope and/or (RAT) remote-controlled parts of slit-lamp, and iris copes. All equipment may be controlled synchronous and asynchronous remotely to perform a medical examination, vision examinations, and/or ocular health examination from the location or distant location simultaneously or at a different time. In contrast, limiting the “store and forward” model more traditional model of telemedicine practice. In contrast the remote eye doctor or health care provider will be using real-time tele-imaging, smartphone imaging, real-time slit-lamp video, control via remote administration tool connection, screen share, screen control, screen viewing to control the robotic parts and supporting real-time patients ocular health images viewing, recording and reviewing with his electronic device virtual reality headset, augmented reality headset, smartphone, smartwatch and/or laptop or personal computer.
 21. The workflow, method, system and apparatus of claim 1, wherein the wireless or wired medical device computer system interface (MCB) control element includes a set of communication interfaces configured to maintain the connection of the several medical devices with the remote health care provider via communicating with one another using the wireless or non wireless, wifi, bluetooth, cellphone wireless networks, internet connection, TCP/IP, Local area network LAN, file sharing protocols, InterPlanetary File System (IPFS) protocols and/or any other communication protocol. Where cellphone wireless networks that can be used are 4G, 5G, 6G or more advance wireless networks. Where the controller or eye doctor or health care provider will be using real-time tele-imaging, smartphone imaging, real-time video, control via remote administration tool connection, screen share, screen control, screen viewing to control any of the equipment robotic parts and supporting real-time patients ocular health images viewing, recording and reviewing with his electronic device virtual reality headset, augmented reality headset, smartphone, smartwatch and/or laptop or personal computer using any wireless or non wireless internet connection.
 22. The workflow, method, system and apparatus of claim 1, wherein the wired or wireless medical instrument interface control first computer system elements is connected and controlled by a second computer system (MCB) where first computer system interface is emulated entirely to the second computing devices. Where a remote controlling via a third computer system can indirectly to directly control all of the medical instrument controls, robotic, mechanical parts, images, cameras, lens meters, retinal cameras, iris-copes, slit-lamp cameras, digital refractors, digital phoropter, automatic phoropter, fluidic phoropter, automatic holographic adaptive phoropter, liquid lens phoropter, fluidic refractor, or any type of phoropter, bluetooth digital phoropter, refractor or optometer type system as long as it is used to refined subjective refraction of a patient. Where all equipments and its parts can be connected to provide telemedicine or telemedicine robotic examinations via indirect to direct connection, direct or direct to direct connection. Where direct to direct connection can be achieved by the second or third computer system controlling the first computer system as long as a remote control softwares is running on the first computer system to interconnect both systems. Where direct connection can be achieved by a physical non remote controller at the location physically controlling the first computer system control software that control the medical or optometric equipment.
 23. The workflow, method, system and apparatus of claim 1, wherein the medical or optometric equipment and first computer system may be a non contact auto refractor apparatus with its computer system can be connected to the secondary computer system. Where the secondary computer system can be controlled by the controller with a third computer system to perform a remote auto-refraction via remote administration tool, screen share, screen control and screen mirroring entire auto refractor user interface onto the third computer system. Where the remote controller a health care provider or a technician a perform an objective refraction by inputting the remote auto refractor results into the any type of phoropter, liquid lens phoropter, liquid lens subjective refractor, automatic holographic adaptive phoropter, automatic phoropter, or digital phoropter with its first computer system mirrored user interface softwares. Where the controller can also take remote auto refractor results for existing contact lenses patient to determine over refraction results if needed to renew prescriptions or to perform remote indirect to direct subjective over refractions. All this can be used to diagnose vision problems, provide prescription extension and contact lens prescription extensions via remote access, remote viewing, remote screen screen sharing, remote controlling, remote printing and remote administration tool technology softwares means. Where if liquid lens subjective refractor are used no need for changing of lenses as it runs on fluid lens actuator system to provide power of lenses. Liquid lenses technology use an electro wetting process to achieve superior autofocus capabilities. The lens itself is a sealed cell with water and oil inside. The electro wetting process shapes the oil drop into an effective lens quickly and accurately. Where using liquid lens technology involves no moving mechanical parts.
 24. The workflow, method, system and apparatus of claim 1, wherein the medical or optometric equipment and first computer system that control the iris-scope and robotic digital slit-lamp can be controlled from the main control base from a remote controller with a third computer system using remote administration tool technology, screen mirror and screen control. A technician or remote controller can give patient instruction to position to view both eyes via an iris-cope and slit-lamp. The controller health care provider or eye doctor can control the remotely the user interface control program running on the secondary computer system MCB. The controller can manipulate remotely the slit-lamp robotic parts to view patients ocular external adnexa realtime or near realtime. Where controller can remotely adjust the slit, white light, cobalt blue filter, magnification angles of the arm via control softwares that controls the servo motors and actuators that can be controlled remotely. Where controller can record images or videos of all part of this remote examination to the softwares inside the MCB. Where via screen mirror, file share the controller may view and diagnose patients ocular conditions depending on remote examinations. All this can be used to diagnose vision problems, provide prescription extension and contact lens prescription extensions via remote means. 